Adequate daily choline intake is set at 550 mg per day and the nutrient was recently added to the Nutritional Facts Panel. Deficiency can cause muscle damage and can lead to the abnormal deposition of fat in the liver, leading to nonalcoholic fatty liver disease (NAFLD). A small percentage of NAFLD suffers can go on to develop cirrhosis. Choline levels are also important in pregnancy, where adequate levels of the nutrient have been liked with lower incidence of neural tube defects. Choline has also been shown to have cognitive benefits and sport recovery benefits.

“​Choline is perhaps one of the most underrated nutrients, yet a large body of evidence supports a range of benefits at all life stages, from maternal health and infant nutrition to healthy aging,​”​said Marie Caudill, PhD, RD and professor in nutritional sciences at Cornell University. Balchem, a leader in choline supply, has developed its branded Vitacholine choline ingredient over a number of years.

Problems with study

A recent study that suggested that too much choline could raise the levels of the bacteria-produced compound called trimethylamine N-oxide (TMAO) as well as causing platelets to clump together and form clots.Tom Druke, director of strategic marketing at Balchem, said in the opinion of the experts his company works with, the study had significant issues and should not be used to make sweeping generalizations about the nutrient.

“​There have been a lot of studies done on choline,​”​ Druke told NutraIngredients-USA. “​This study on TMAO is one data point within that broad narrative coming out of the lab. There are some conclusions being made that just aren​’​t warranted in our opinion.​”​

Druke said Balchem’s science team had some fundamental questions about the design and methodology of the recent study, which was published in the journal Circulation.

“​It was a very small scale study​—​just 18 participants. And we don​’​t know what platelet aggregation method was used, which could affect the results,​”​ he said.

Choline was recognized as an essential nutrient by the Institute of Medicine back in 1998, mostly for its important role in the transport of fat out of the liver, Druke said. It was added to the Nutrition Facts Panel in its most recent revision after a recognition that most Americans don’t get enough choline in the diet, he said.